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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(01): E37-E49
DOI: 10.1055/a-1629-7540
Original article

UK Joint Advisory Group consensus statements for training and certification in endoscopic retrograde cholangiopancreatography

Keith Siau
 1   Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK
 2   Medical and Dental Sciences, University of Birmingham, Birmingham, UK
,
Margaret G Keane
 3   Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Helen Steed
 4   Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
 5   Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
,
Grant Caddy
 6   Department of Gastroenterology, South Eastern Health and Social Care Trust, Northern Ireland, UK
,
Nick Church
 7   Department of Gastroenterology, NHS Lothian, Edinburgh, Scotland
,
Harry Martin
 8   Department of Gastroenterology, University College London Hospitals, London, UK
,
Raymond McCrudden
 9   Department of Gastroenterology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
,
Peter Neville
10   Department of Gastroenterology, Cwm Taf Morgannwg Health Board, Merthyr Tydfil, UK
,
Kofi Oppong
11   Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
,
Bharat Paranandi
12   Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
,
Ashraf Rasheed
13   Department of Surgery, Aneurin Bevan University Health Board, Newport, UK
,
Richard Sturgess
14   Department of Gastroenterology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
,
Neil D Hawkes
10   Department of Gastroenterology, Cwm Taf Morgannwg Health Board, Merthyr Tydfil, UK
,
George Webster
 8   Department of Gastroenterology, University College London Hospitals, London, UK
,
Gavin Johnson
 8   Department of Gastroenterology, University College London Hospitals, London, UK
,
on behalf of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) › Author Affiliations
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UK Joint Advisory Group consensus statements for training and certification in endoscopic retrograde cholangiopancreatographyEndosc Int Open 2022; 10(01): C1-C1
DOI: 10.1055/a-1761-7848

Abstract

Background and study aims Despite the high-risk nature of endoscopic retrograde cholangiopancreatography (ERCP), a robust and standardized credentialing process to ensure competency before independent practice is lacking worldwide. On behalf of the Joint Advisory Group (JAG), we aimed to develop evidence-based recommendations to form the framework of ERCP training and certification in the UK.

Methods Under the oversight of the JAG, a modified Delphi process was conducted with stakeholder representation from the British Society of Gastroenterology, Association of Upper Gastrointestinal Surgeons, trainees and trainers. Recommendations on ERCP training and certification were formulated after formal literature review and appraised using the GRADE tool. These were subjected to electronic voting to achieve consensus. Accepted statements were peer-reviewed by JAG and relevant Specialist Advisory Committees before incorporation into the ERCP certification pathway.

Results In total, 27 recommendation statements were generated for the following domains: definition of competence (9 statements), acquisition of competence (8 statements), assessment of competence (6 statements) and post-certification support (4 statements). The consensus process led to the following criteria for ERCP certification: 1) performing ≥ 300 hands-on procedures; 2) attending a JAG-accredited ERCP skills course; 3) in modified Schutz 1–2 procedures: achieving native papilla cannulation rate ≥80%, complete bile duct clearance ≥ 70 %, successful stenting of distal biliary strictures ≥ 75 %, physically unassisted in ≥ 80 % of cases; 4) 30-day post-ERCP pancreatitis rates ≤5 %; and 5) satisfactory performance in formative and summative direct observation of procedural skills (DOPS) assessments.

Conclusions JAG certification in ERCP has been developed following evidence-based consensus to quality assure training and to ultimately improve future standards of ERCP practice.



Publication History

Received: 26 February 2021

Accepted: 24 August 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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